Most of us have experienced the symptoms of dry eye at some point in our lives. In some cases, it may have just been a short-lived discomfort as you sat through a long-haul flight; for others, it may be a more debilitating condition that requires intensive dry eye treatment. Research tells us the prevalence of dry eye around the world is as high as 50%. However, many people with dry eye syndrome go undiagnosed, as the symptoms of dry eye aren’t always what you might think.
What is Dry Eye Syndrome?
Dry eye syndrome is a recognised eye disease characterised by a compromised tear film and inflammation of the eye’s surface. The tear film is a layer of moisture that covers the front surface of the eye, including our very sensitive cornea. In addition to playing a role in directing the passage of light through the eye crucial for vision, the tear film also keeps our eyes protected from pathogens and the environment.
There are two basic categories of the dry eye depending on its underlying cause – aqueous deficiency dry eye (ADDE) and evaporative dry eye (EDE). ADDE to problems with the aqueous (watery) layer of the tear film, such as from certain autoimmune diseases, medications, or contact lens wear. EDE occurs when the tear film is unstable and quickly evaporates into the environment, leaving the cornea exposed. Similar to aqueous deficiency causes, EDE may be caused by contact lens wear, medications, and other health conditions, but is most commonly due to a dysfunction of the oil glands in the eyelid. Other factors that may contribute to dry eye syndrome include:
- Older age
- Decreased blinking, often associated with intense visual work such as computer work or reading
- Blepharitis, an inflammatory eyelid condition
- Vitamin A deficiency
- Environmental conditions, such as smoke or wind
- Ocular allergies
In reality, most people will experience a combination of both ADDE and EDE. Identifying the predominant contributor to your dry eye is key for your eye care professional in recommending the most appropriate dry eye treatment.
What are the Symptoms of Dry Eye?
The symptoms of dry eye are more than simply the eyes feeling dry. In fact, to complicate things further, there are some people who feel their eyes are dry and yet still have a healthy tear film. Conversely, you may have never identified your eyes as feeling dry and yet still have a compromised ocular surface.
Here are some of the common symptoms of dry eye you may have not thought about.
- A gritty, stinging, burning, scratchy sensation in the eye. Some people will also feel that there is a foreign particle lodged in the eye. In reality, the exposure of your cornea to the environment from an inadequate tear film is responsible for these sensations.
- Compromised vision. As mentioned earlier, the tear film contributes to the bending, or refraction of light as it passes through the front surface of the eye. If the tear film is uneven, unstable, or contains debris, it will disrupt this passage of light, leading to blurry or fluctuating vision. You may find this most apparent in specific situations, such as when reading smaller print or driving at night. Blinking will often help to clear your vision but only fleetingly.
- Difficulty with contact lens wear. Although contact lens materials are designed to be biocompatible with the eye, it continues to be the holy grail of contact lens innovation to find a lens material that does not disrupt the tear film. Unfortunately, many patients with dry eyes still find they are limited in how long they can wear their contacts or are entirely unsuitable for contact lens wear due to discomfort.
- Glare sensitivity. Similar to its effects on your clarity of vision, an unstable or uneven tear filam may induce glare sensitivity or photophobia. This can make screen time more uncomfortable, especially towards the end of the day as you get more tired.
- Watery eyes. Counterintuitively, dry eyes may cause reflexive tearing, which results in watery eyes, also known as epiphora. This is your body’s way of trying to lubricate a dry eye’s surface.
- Red eyes. Inflammation on the surface of your eye is one of the hallmarks of dry eye disease. This results in the whites of your eyes taking on a red tinge; in some cases, the redness may be quite pronounced.
- Mild mucous discharge. While discharge is often associated with conjunctivitis or an eye infection, a depleted tear film may cause a stringy mucous discharge.
Dry Eye Treatment
For the most effective dry eye treatment, it’s recommended to see your eye care professional, whether optometrist or ophthalmologist, for a comprehensive eye exam. If your eyes are only mildly dry, you may choose to self-manage by using topical eye drop lubricants, which can be obtained off the shelf at your local pharmacy or supermarket. Making modifications to your environment or lifestyle can also make a big difference to your dry eye symptoms. You can consider:
- Redirecting heating or cooling vents away from your face
- Reducing the brightness of your screen to alleviate glare
- Asking your optometrist to refit you in a different contact lens material
- Being mindful of blinking your eyes frequently when reading or using a screen
- Quitting smoking
Your eye care professional can help you manage your symptoms by recommending specific management strategies. These include IPL (intense pulsed light) treatment, the insertion of punctal plugs, warm compresses with lid massage, or changes to your diet. For severe, persistent cases of dry eye, your eye care professional may also prescribe you medicated eye drops, such as an anti-inflammatory or immunosuppressant.
If you suspect you suffer from dry eye disease, it’s worth a visit to your optometrist or ophthalmologist for help in managing your symptoms. Call us now on (03) 9070 5753.